title: Pringle maneuver exacerbates systemic inflammatory response and multiple-organ injury induced by extended liver radiofrequency ablation.
abstract: OBJECTIVE
  To assess the systemic inflammatory response (SIR) and the multi-organ damage after large-volume liver radiofrequency ablation (RFA) with or without concurrent Pringle maneuver.
  
  
  METHODS
  Wistar rats were subjected to 30% liver RFA (group RFA), liver RFA under 30-min Pringle maneuver (group RFA + P), Pringle only (group P) or sham operation (group S). Serum levels of interleukin-1α (IL-1α), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), serum biochemical profile, multiple-organ pathology and the activity of nuclear factor-κB (NF-κB) in the liver were assessed post-operatively.
  
  
  RESULTS
  The levels of IL-6 and TNF-α were increased from 1h up to 1w and 6h, respectively, in both RFA groups, while IL-6 was only mildly increased at 3 h in group P. IL-6 was higher in group RFA + P compared to group RFA. Serum biochemical profile was altered more intensely in group RFA + P compared to RFA. There was tissue injury in the non-ablated liver portion as well as in adjacent and remote organs with lesions being more severe in group RFA + P. At 1 h, NF-κB was equally activated in all study groups.
  
  
  CONCLUSIONS
  Extended liver RFA causes SIR and multi-organ injury, which are exacerbated when a concurrent Pringle maneuver is applied.
authors.affiliation: Laboratory of Experimental Surgery and Surgical Research, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece. pipsil@med.duth.gr
authors.forename: Petros
authors.initials: P
authors.lastname: Ypsilantis
authors.forename: Maria
authors.initials: M
authors.lastname: Lambropoulou
authors.forename: Constantinos
authors.initials: C
authors.lastname: Anagnostopoulos
authors.forename: Christina
authors.initials: C
authors.lastname: Tsigalou
authors.forename: Constantinos
authors.initials: C
authors.lastname: Vasiliadis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Kortsaris
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papadopoulos
authors.forename: Constantinos
authors.initials: C
authors.lastname: Simopoulos
mesh_terms: D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D017115:Catheter Ablation / Q000009:adverse effects*; D015850:Interleukin-6 / Q000097:blood; D008099:Liver / Q000378:metabolism / Q000601:surgery*; D009102:Multiple Organ Failure / Q000209:etiology* / Q000378:metabolism; D016328:NF-kappa B / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology* / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015850:Interleukin-6; D016328:NF-kappa B; D014409:Tumor Necrosis Factor-alpha; D001219:Aspartate Aminotransferases; D001663:Bilirubin